|8th August 2016
The last few years have seen a huge proliferation in the number of products entering the oncology space, with a lot more currently being investigated in clinical trials. This is flooding the marketplace with treatment options but also bringing a great level of confusion to physicians, payers and patients.
Effective positioning in this situation is vital to cut through the noise and allow your customers to short-circuit a treatment decision when they diagnose a patient with a particular disease. Immuno-oncology products are bringing even greater complexity to this problem.
Here, we outline some key points we've learned from our recent extensive experience in this area.
The cancer landscape is changing. Immunotherapeutic advances are driving significant improvements in treatment options for sufferers of many types of cancers and blood disorders. These changes, in turn, are having a fundamental impact on approaches to treatment and standards of care in the same way that surgery, radiotherapy, and chemotherapy have done in the past.
Changing the structure of the market in this way is leading to a lot of excitement amongst stakeholders of all kinds, from patients and carers to specialists and nurses. However, we are reaching a stage now where we cannot just rely on the ‘immuno-oncology’ trend in order to generate buzz.
This means that it’s necessary to show specificity and differentiation; particularly across and between inhibitory and activating targets of the novel immunotherapeutic products of today.
Within solid tumours, checkpoint inhibitors, particularly PD-(L)1s, are the source of a lot of excitement, as many have shown genuinely astounding improvements in survival over previously established standards of care. These products work across a multitude of tumour types, and opportunities for further developments and trials seem to be ceaseless. In addition, developments in oncolytic viruses mean the options for patients with certain solid tumours are ever-expanding. Within blood cancers, PD-(L)1s and also monoclonal antibodies, in particular CD38s, are redefining the approach to treatment.
In order to best deliver for your customers, we first need to truly understand who the customer is that we’re trying to appeal to. This is difficult when there are so many stakeholders involved in the treatment decision, across a number of specialty types and job roles. The key to effectively delivering for these customers is to establish a credible, specific, and game-changing position in their minds.
A key component of this is expressing the benefits of the product in a way that redefines expectations of value; from a patient, physician, and payer’s perspective. Value is a function of outcomes and cost, with overall survival a critical component. Despite the groundbreaking overall survival data for many new immuno-oncology products, the unique mechanisms of action of some of these products, particularly checkpoint inhibitors, means that they may take longer to show improvements in disease progression. They may even show tumour growth in some instances, as it takes time to recruit T-Cells. As such, it is important to also incorporate secondary endpoints into the discussion early, namely around safety and tolerability.
Despite data that offers improvements in multiple areas over current or established standards of care, the proliferation of these new products and their data means the marketplace across and within tumour types is becoming increasingly crowded. This is causing confusion for customers. The clinical endpoint trap must be avoided, where brands focus their position purely on data. This is not an enduring strategy, as the data is changing so quickly that stakeholders’ expectations are constantly being redefined. For this reason, it is more important than ever to take an emotive position when coming to market, aligning data with desires and needs of key stakeholders. We should look for trigger points from an emotive perspective that are consistent or linked across key stakeholders to increase the strength and resonance of the positioning.
As we have discussed already, immuno-oncology products of today are generally not tumour specific, instead working on specific targets or pathways that are active across different cancer types. This has an interesting implication on positioning as it means that individual products must be positioned in such a way that usage in their first indication or tumour type is clear, but that also sets up to take advantage of the future opportunity across tumour types.
Due to the number of new mechanisms of action being tested and the relatively ‘clean’ profile of immuno-oncology products, they are prime candidates for combination therapy. A number of these products are being tested both in mono- and combination therapy already and within these trials, many combinations being tested use products from different companies. This brings an additional complexity to positioning. Under normal circumstances, it is critical to establish a clear and distinct positioning for your product – doing so well is often to the detriment of your competitors, resulting in repositioning them as an inferior option. In this instance though, it may not be in your interest to reposition other treatments in this way, if they provide an opportunity for the future in combination. So not only do you need to develop a distinct position for your product, establishing it as the number one option, you must also be cognizant of future combination opportunities and ensure that your position lends itself to being the preferred backbone when physicians consider these combinations.
Another major benefit of strong and aspirational positioning is that it can support an internal mindset shift. It can be used to build confidence in the product, and then cascade that through cross-functional teams informing future data generation, market access approaches, marketing and medical activity.
The nature and structure of brand teams for immuno-oncology products is changing given the multiple indications and tumour types these products work in. There is a trend toward tumour teams, rather than overall brand teams, while some have dedicated combination teams. It is important to bring all of these teams together under one consistent positioning and approach, to inform future activity across functions in a clear, strategic way.
In ensuring consistency, the multiple indications must be considered, as well as future opportunities in additional indications and combinations, either with owned or competitor products. The positioning must take a long term view and be reviewed regularly to ensure it still aligns with quickly changing customer needs and expectations in ever more competitive market places.
Immuno-oncology products are redefining approaches to and expectations of treatment across cancer types. They are also developing a market situation where traditional or fixed approaches to positioning are no longer appropriate. Products are now suitable for a wide range of customers, competitive products may now be seen as critical to the long-term success of your brand, and internal teams need, more than ever, clear direction and a positioning strategy that drives clear behavior change across functions. These aspects will help to establish a foundation for your brand that is enduring and effective in a marketplace that is not yet defined.
Blue Latitude Health have worked on a number of immuno-oncology and wider oncology products in recent years and have developed a flexible process for positioning to accommodate current and future market trends and dynamics. Get in touch at firstname.lastname@example.org to find out how we may be able to support you in your product launch.
|9th July 2019
Dr Stuart Adams specialises in using T-cell therapy to treat paediatric patients at Great Ormond Street Hospital. Here, he explains what it was like to develop and deliver a groundbreaking CAR-T therapy for the first patient in Europe, and how the centre of excellence has adapted to make precision medicine a reality
|20th June 2019
Dr Mark Moasser treated breast cancer survivor Laura Holmes-Haddad (interviewed in part one) with an innovative precision medicine, which at the time was yet to be approved. Here he gives his side of the story and explains how industry can help oncologists treat more patients with targeted therapies.